Provider Demographics
NPI:1760495584
Name:PROS HOME HEALTHCARE, INC
Entity Type:Organization
Organization Name:PROS HOME HEALTHCARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CCO
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MARBERRY
Authorized Official - Suffix:
Authorized Official - Credentials:DELEGATED AUTHORITY
Authorized Official - Phone:903-390-4040
Mailing Address - Street 1:8751 COLLIN MCKINNEY PKWY STE 1102
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-1872
Mailing Address - Country:US
Mailing Address - Phone:903-390-4040
Mailing Address - Fax:
Practice Address - Street 1:1544 SAWDUST RD STE 180
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77380-2902
Practice Address - Country:US
Practice Address - Phone:903-390-4040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX003864OtherHHSC LICENSE FOR HOME HEALTH
TX160236901Medicaid
TX45D0935006OtherCLIA